Individual
MR. MARK DURANT PRESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
306 HOMEPARK RD, KINGSTON, TN 37763-4434
(865) 376-3474
(865) 717-0182
Mailing address
306 HOMEPARK RD, KINGSTON, TN 37763-4434
(865) 376-3474
(865) 717-0182
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
414
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4130415
BCBS OF TN
TN
Enumeration date
05/08/2007
Last updated
07/08/2007
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